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Let’s talk about period pain – could you have endometriosis?

In the UK, around 1.5 million women suffer from endometriosis. In practical terms, that is 1 in 10 women having debilitating pain during their period. Could you or someone you know be one of these women?

Endometriosis is a condition where cells like the ones in the womb (endometrium) are present in other organs such as the ovaries, fallopian tubes, bladder and intestine. These cell adhesions behave like the cells in the womb, expanding during your cycle and then breaking down and bleeding when you have your period. However, unlike the blood from the cells in your womb, the blood from these cells cannot escape the body and builds up causing pain, inflammation and scarring. Endometriosis affects mainly girls and women of childbearing age and is a long-term condition that can affect a woman’s chances of getting pregnant.

What are the symptoms?

The symptoms vary from woman to woman, some may be severely affected whilst others do not feel any symptoms. The main symptoms are:

- Extremely painful, heavy periods
- Prolonged periods
- Pain during ovulation
- Pain during or after sex
- Pain when pooing or peeing during a period
- Spotting or bleeding between periods
- Blood in your pee or poo when on a period
- Feeling sick, constipated or having diarrhoea when on a period
- Pelvic and back pain
- Feeling tired, with lack of energy and depressed

Endometriosis can be classified into minimal, mild, moderate or severe according to the American Fertility Society (AFS) revised classification of endometriosis score. However, this classification does not always correlate with the degree of pain, it is possible to have severe pain with minimal endometriosis and minor pain with severe endometriosis.

What is the difference between normal period pain and endometriosis period pain?

Women with endometriosis usually start feeling period pains in the days before their period. Once they get their period the pain can be so intense that they are not able to do their normal activities and often have to miss school or work. It can take an average of 7.5 years to get a diagnosis in the UK so if you think you have endometriosis it is important that you speak to your GP about it.

How is endometriosis treated?

Currently there is not a cure for endometriosis and the treatments available aim to reduce the severity of symptoms and improve the quality of life of women with the condition. If you have endometriosis, a healthcare profession will discuss with you the treatment options available. These usually are:

- Pain relief using painkillers
- Hormone treatment with the contraceptive pill, patches or an intrauterine system (IUS)
- Keyhole surgery (laparoscopy) to remove endometriosis tissue

Does endometriosis affect a woman’s chances of getting pregnant?

The short answer is yes. Although the cause is not fully known yet, with increasing severity of endometriosis women experience more difficulty in conceiving. In cases of moderate to severe endometriosis, the blood from the cell adhesions present in the ovaries and fallopian tubes can interfere with ovulation and cause blockages that prevent the egg and sperm to move along the fallopian tube.

What can women with endometriosis do to improve their chances of getting pregnant?

The best thing is to speak to your doctor. In some cases of minimal to mild endometriosis, the surgical removal of areas of endometriosis can improve the chances of pregnancy. In other cases, fertility treatment can also be used to achieve a pregnancy in women with endometriosis.

Support systems for women dealing with endometriosis

Endometriosis can have a profound impact on a women’s life both physically and psychologically. In addition to support from the doctor, many women find it helpful to speak to others in the same situation to share experiences, advice and opinions. Endometriosis UK is a support group that aims to spread awareness about endometriosis and promote research to help improve the quality of life of women living with endometriosis.

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